Date of Award

Spring 5-11-2018

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Sheryl Strasser

Second Advisor

Dr. Xiangming Fang


INTRODUCTION: Alzheimer’s Disease (AD)is currently listed as the sixth leading cause of death among U.S. adults, killing more people than breast cancer and prostate cancer combined. While the number one risk factor for AD is increasing age, to date, little is known about preventive or protective factors of AD. Continued epidemiologic research that seeks to examine risk and protective factors, such as the role educational attainment plays in cognitive functioning among those with AD may offer important preventive insights.

AIM: The purpose of this study is to examine the correlation between education level and the cognition of persons with AD. An extensive data set was used that collects data from various locations, which will make for more reliable results. Ultimately, the hope is that interventions will be implemented to combat the detection bias due to later diagnosis of dementia (AD) in highly educated persons (Karp et al., 2002).

METHODS: The National Alzheimer’s Coordinating Centers (NACC) dataset from (2005-2017) was used to examine associations of cognitive function / impairment with variables related to sample demographics, health history, neuropsychological testing, risk behaviors, and education. Tests of correlation, ordinary least square, and logic regression tests were conducted to examine the relationship between cognitive impairment and educational attainment, along with possible co-variates.

RESULTS: There was a small positive correlation between subjects with an education and MMSE score, (r=0.2561, p < .05). For a one unit increase in the years of education was associated with a 0.341 (SD, 0.011) increase in MMSE Score. For a change in the education group 13-16 years and education group >16 years there is a 2.056 (SD, 0.090) and a 2.658 (SD, 0.097) unit change in MMSE score respectively. As the continuous education variable increased the AD diagnosis decreased by 0.067 (SD, 0.005). As education group 13-16 and >16 years changed from one group to the other AD diagnosis decreased (-0.488, SD 0.040 and -0.629, SD 0.043).

DISCUSSION: Results from this study may be theoretically explained-that higher educational attainment may be associated with a fundamentally higher cognitive reserve among older adults who have cognitive disorders. The lower likelihood of AD pathology may be associated with higher functioning or potentially a lower diagnosis of AD. The role education plays among older adults with cognitive disorder diagnoses appears to be linked, yet this relationship, with AD pathology in particular, warrants further research attention.

Available for download on Monday, April 29, 2019